(Reuters Health) – Kindergarteners who get more than two hours of screen time a day may be more likely to have behavior and attention problems in school than their classmates who spend less time in front of televisions, smartphones and tablets, a Canadian study suggests. Doctors urge parents of young kids to limit screen time or avoid it altogether because all of those hours watching videos or gaming have been linked to slowed development of speech and language, fine and gross motor skills, and social and behavioral skills. After all, time spent in front of screens means less time for scribbling with crayons or playing games that help kids learn how to kick a ball or take turns. In the current study, researchers surveyed parents of more than 2,400 Canadian kids to assess screen time at three and five years. The second assessment also asked about behavior problems like inattention and aggressiveness as well as issues like sleep difficulties, depression, and anxiety. Very few five-year-olds had these problems: just 1.2 percent of kids had so-called “externalizing” behavior problems like aggression or inattention and just 2.5 percent had “internalizing” problems like depression and anxiety. But compared to kids who got less than a half hour of screen time daily, children who had more than two hours daily had an almost six-fold greater risk of attention problems and an almost eight-fold greater risk of meeting the criteria for attention-deficit/hyperactivity disorder. “It is never too early to talk to your child about limiting screen time,” senior study author Dr. Piush Mandhane of the University of Alberta in Canada said by email. Canadian guidelines recommend that parents limit screen time to less than one hour a day for children two to four years old and less than two hours daily for older kids, researchers note in Plos One. At age three, kids in the study exceeded these limits, getting an average of 1.5 hours a day of screen time. They got slightly less – 1.4 hours a day – by age five. Overall, almost 14 percent of kids had more than two hours a day of screen time. It’s possible that some kids in the study who already had challenges with behavior or social skills opted to spend more time in front of screens because they struggled to relate to peers. The study also wasn’t a controlled experiment designed to prove whether or how screen time might cause behavior problems. “This study does not draw any conclusion about certain types or contexts of media use being better for child development than others,” said Andrew Ribner, a psychology researcher at New York University who wasn’t involved in the research. “However, other research has suggested screen time that has a slower pace, is relatively less fantastical, and provides some kind of contingent responsiveness â€” something like Sesame Street or Dora the Explorer rather than Spongebob Squarepants â€” is better than the alternative,” Ribner said by email. Fast-paced digital media can precondition little ones to expect unnatural stimulation, leading to shorter attention spans because real life can seem slow and underwhelming by comparison, said Dr. Dimitri Christakis, director of the Center for Child Health, Behavior and Development at Seattle Children’s Research Institute. “We also know from decades of research that real, human interaction and play is critical to cognitive and social development,” Christakis, who wasn’t involved in the study, said by email. “Even if it were ‘harmless,’ the time spent on digital devices displaces these interactions.” Beyond just limiting screen time, parents should concentrate on creating screen-free times in children’s daily routines, said Dr. Jenny Radesky of the C. S. Mott Children’s Hospital at the University of Michigan in Ann Arbor. “The more important thing is reducing tech distractions during meals, when playing solo or together, and before bedtime – and not giving in to every moment of boredom or whining with tech use,” Radesky, who wasn’t involved in the study, said by email. “It’s so important for children to learn how to handle big feelings, tolerate boredom, and settle themselves down at night.” SOURCE: bit.ly/2Wa1uNc PLoS One, online April 17, 2019.